The Impact of 2014’s Legislative Session and Will Missouri Expand Medicaid in 2015?

(St. Charles, MO) – The regular session may be over for Missouri lawmakers but the politics and the decisions that impact you are not.

On “Missouri Viewpoints”, Speaker of the House Tim Jones (R) and State Senator Scott Sifton (D) look back at the now-completed Legislative Session and look ahead to the upcoming veto session.

Jones calls the 2014 effort “…a significant, substantive session where we solved some major issues and challenges facing Missouri.”

To him, the crowning achievement was overriding Governor Jay Nixon’s veto and putting a tax cut in place. If the state’s economy hits specific benchmarks, the tax cuts will be phased in starting in 2017.

Both Jones and Sifton say one of the most controversial issues of 2013 and 2014 will likely return for debate next year as well. That’s the push to take federal money and expand Medicaid coverage in Missouri as part of the Affordable Care Act (also known as “ObamaCare”).

There was a very small amount of Republican support for some expansion this year although the vast majority of Republicans still oppose the idea. To Sifton, that’s enough to see momentum in the effort.

“I think you saw the beginnings of bipartisan efforts to get the job done on Medicaid expansion.”

Jones disagrees. While he won’t be in the Legislature after this year due to term limits, he does not believe expansion will happen in 2015. He does think Medicaid will be addressed in another way, though.

“I think you’re going to see a Medicaid reform bill first.”

The Speaker points out that about one in five Missourians is currently either already on Medicaid or is eligible for Medicaid as things stand now. He says tackling problems within the system would remove from the rolls those who should not be on the system, making room for those who should.

“Instead of just throwing more people on a state subsidized free health care system, we need to be making sure that the right people are in that system. When you talk to the health care providers, they tell you the level of fraud, waste and abuse is astronomical.”

While Sifton wants to see expansion as soon as possible, he agrees that some reform measures will have to be addressed before there’s much chance of the state increasing eligibility.

“I think we recognized from the very beginning that simply increasing the eligibility threshold to 138% [of the national poverty level] without trying to reform Medicaid or implement other cost controls, it’s just not realistic.”

While Republicans are generally content to take a measured approach and are in no hurry to deal with the expansion proposal, Sifton believes it is an urgent issue that has a larger impact on the state.

“Missouri hospitals are losing five million dollars a day because of the effect of the Affordable Care Act, absent Medicaid expansion and that’s a cost our health care system simply can’t bear. It’s bad for patients, it’s bad for hospitals and it’s bad for everybody.”